Clinical Outcomes and Cost of the Moderately Preterm Infant

Kirkby, Sharon; Greenspan, Jay S.; Kornhauser, Michael; Schneiderman, Roy

doi:10.1097/01.anc.0000267913.58726.f3

Cited by 72 publications

(59 citation statements)

References 16 publications

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“…The cost of managing ELBW infants varies between developed and developing countries and different regions within a country 4,6,15,16 17 . In the South African study 14 , mean duration of mechanical ventilation was 8.08 days and the mean duration of supplemental oxygen was 8.2 days in VLBW babies.…”

Section: Discussionmentioning

confidence: 99%

Short term outcome, complications and average direct cost in managing extremely low birth weight infants in a tertiary care centre in Sri Lanka

Nelumdeniya¹,

Silva²,

Nanayakkara³

et al. 2012

Sri Lanka J Child Health

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Section: Discussionmentioning

confidence: 99%

Short term outcome, complications and average direct cost in managing extremely low birth weight infants in a tertiary care centre in Sri Lanka

Nelumdeniya¹,

Silva²,

Nanayakkara³

et al. 2012

Sri Lanka J Child Health

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“…The original DIVA score defined history of prematurity as patients born at less than 38 weeks' gestational age, thus giving patients born at 37 weeks and 6 days the same score as those patients born at 24 weeks of gestation. The impetus for gathering NICU LOS data was the belief that there is a difference between extreme preterm and near-term infants 5,6 and that these differences may contribute to difficulty with venous cannulation. Ultimately, NICU LOS was transformed to history of NICU admission, yes or no due to paucity of children in this study who were born premature.…”

Section: Methodsmentioning

confidence: 99%

Validation and Refinement of the Difficult Intravenous Access Score: A Clinical Prediction Rule for Identifying Children With Difficult Intravenous Access

Riker

Kennedy

Winfrey

et al. 2011

Academic Emergency Medicine

113

109

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Objectives: The difficult intravenous access (DIVA) score, a proportionally weighted four-variable (vein palpability, vein visibility, patient age, and history of prematurity) clinical rule, has been developed to predict failure of intravenous (IV) placement in children. This study sought to externally validate and refine the DIVA score.Methods: Patients undergoing peripheral IV placement by pediatric emergency department (ED) nurses were enrolled. The outcome of interest was defined as failure of cannulation on first attempt. Proposed refinement predictor variables include history of newborn intensive care unit (NICU) stay, operator experience characteristics (years since graduation, years of pediatric nursing experience, and IVs started per month), and skin shade. Adjusted multivariate models were constructed using logistic regression. Receiver operating characteristic (ROC) curves were constructed and areas under the curve (AUC) calculated for each model. Results:A total of 366 subjects were enrolled (mean age = 5.4 years, SD ± 5.6 years) and of them, 118 (32.2%) subjects failed the first IV attempt. The original four-variable model tested in this data set resulted in an AUC of 0.72 (95% confidence interval [CI] = 0.67 to 0.78). Patients with a DIVA score of 4 or greater had more than 50% likelihood of failed first IV attempt. A three-variable rule (vein palpability, vein visibility, and patient age) was evaluated and found to possess similar discriminating ability (AUC = 0.72, 95% CI = 0.67 to 0.78).Conclusions: This study validated the previously derived four-variable DIVA score. A simpler threevariable rule was as predictive of failed IV placement on first attempt as the four-variable rule. Validation in nonpediatric EDs is needed to thoroughly evaluate generalizability.

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“…2- 4 The increased risk of adverse sequelae following LMPT birth is likely to translate into economic consequences for health services and other sectors of the economy, 5 the study of which has been highlighted as a priority area for research enquiry. 6 A recent structured review summarising published evidence on the economic consequences of LMPT birth, 6 found that ten studies, published between 1980 and 2011, focused on economic costs during the infant's initial hospitalisation, [7][8][9][10][11][12][13][14][15][16] whereas 13 studies reported economic costs in some form following the infant's initial hospitalisation.…”

Section: Introductionmentioning

confidence: 99%

Economic costs associated with moderate and late preterm birth: a prospective population‐based study

Khan

Petrou

Dritsaki

et al. 2015

BJOG

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Objective We sought to determine the economic costs associated with moderate and late preterm birth.Design An economic study was nested within a prospective cohort study.Sample Infants born between 32 +0 and 36 +6 weeks of gestation in the East Midlands of England. A sample of infants born at ≥37 weeks of gestation acted as controls.Methods Data on resource use, estimated from a National Health Service (NHS) and personal social services perspective, and separately from a societal perspective, were collected between birth and 24 months corrected age (or death), and valued in pounds sterling, at 2010-11 prices. Descriptive statistics and multivariable analyses were used to estimate the relationship between gestational age at birth and economic costs.Main outcome measures Cumulative resource use and economic costs over the first two years of life.Results Of all eligible births, 1146 (83%) preterm and 1258 (79%) term infants were recruited. Mean (standard error) total societal costs from birth to 24 months were £12 037 (£1114) and £5823 (£1232) for children born moderately preterm (32 +0-33 +6 weeks of gestation) and late preterm (34 +0 -36 +6 weeks of gestation), respectively, compared with £2056 (£132) for children born at term. The mean societal cost difference between moderate and late preterm and term infants was £4657 (bootstrap 95% confidence interval, 95% CI £2513-6803; P < 0.001). Multivariable regressions revealed that, after controlling for clinical and sociodemographic characteristics, moderate and late preterm birth increased societal costs by £7583 (£874) and £1963 (£337), respectively, compared with birth at full term.Conclusions Moderate and late preterm birth is associated with significantly increased economic costs over the first 2 years of life. Our economic estimates can be used to inform budgetary and service planning by clinical decision-makers, and economic evaluations of interventions aimed at preventing moderate and late preterm birth or alleviating its adverse consequences.

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Clinical Outcomes and Cost of the Moderately Preterm Infant

Cited by 72 publications

References 16 publications

Short term outcome, complications and average direct cost in managing extremely low birth weight infants in a tertiary care centre in Sri Lanka

Short term outcome, complications and average direct cost in managing extremely low birth weight infants in a tertiary care centre in Sri Lanka

Validation and Refinement of the Difficult Intravenous Access Score: A Clinical Prediction Rule for Identifying Children With Difficult Intravenous Access

Economic costs associated with moderate and late preterm birth: a prospective population‐based study

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